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Maine Regulation Digest / MaineCare Section 109

Hornbeam reads MaineCare's publications every night and records what changed, quoting the source.

MaineCare Section 109

Speech and Hearing Services

10-144 C.M.R. ch. 101 · MaineCare Benefits Manual · monitored nightly · Sources last checked 2026-09-02 04:24 EDT

MaineCare Section 109, Speech and Hearing Services, has 4 confirmed changes on record, the most recent effective 1 January 2026. Each row below carries the value it moved from and the value it moved to. The line above each group names the publication that announced those changes and links to it.

Changes on record

Changes on record, newest effective date first.
What changedWasNow
2026
Effective 1 January 2026 · 4 rate changesCR 138462 · detected 2026-08-12
What changedUpdate the MaineCare reference rate for procedure code 92524 to $76.47.# Was Now$76.47
What changedUpdate the MaineCare reference rate for procedure code 92545 to $11.45.# Was Now$11.45
What changedUpdate the MaineCare reference rate for procedure code 92607 to $84.93.# Was Now$84.93
What changedUpdate the MaineCare reference rate for procedure code 92620 to $61.79.# Was Now$61.79
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What the rule says

From MaineCare Benefits Manual, 10-144 C.M.R. ch. 101, as published by the Maine Secretary of State and read on an earlier revision. Quoted in part; the section itself is on maine.gov.

MaineCare coverage of Speech and Hearing Services is limited. Refer to Chapter II, Section 109.08 for specific limitations. Use the following modifiers whenever appropriate, as well as any other HIPAA compliant billing modifiers not listed below that apply to the service. The Modifier(s) column below is for reference only. Professional judgment of Qualified Professional Staffing in accordance with 109-09.3 should make the final determination.

Modifier GN if services are delivered under an outpatient speech-language pathology plan of care.

Modifier TF applicable for Assistant services.

Modifier HQ for group services (two (2) to four (4) members with one clinician).

Modifier 52 if the service is reduced, or applied to one ear and not both.

Modifier TL for services performed under an Individualized Family Service Plan (IFSP).

Modifier TM if performed under an Individualized Education Plan (IEP) with MaineCare Addendum.

Modifier 22 if the work required to provide a service is substantially greater than typically required. (Documentation must be submitted with the provider claim that supports the substantial additional work and the reason for that additional work. If so, after manual clinical review by the Department or authorized agent, the provider will receive an additional twenty-percent (20%) reimbursement for the service.

The Independent Rate applies to organizations with either one or more Speech Language Pathologist or Audiologist.

Billing

Code

Modifier(s)

[…] The section continues on maine.gov.

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